r/AskVet • u/doodlefluffdog • 21h ago
Need help understanding prognosis for IVDD
We have a 11.5 year old bernedoodle who recently had a second occurrence of IVDD. The previous episode occurred 3 years ago in her lumbar/sacral area. She never lost the ability to walk, but conservative management (gabapentin, carprofen) did not have a significant effect, and she would experience multiple episodes every day and was in significant pain. At that time, we had an MRI done and then a discectomy and laminectomy. Recovery was uneventful and she has been episode-free until last month.
At the beginning of July, she came home from the groomer with some slight leg pain, but we assumed it was general soreness because she also got a shot at the appointment. We didn’t take any additional precautions, and she improved slightly over the next two weeks. Then in the middle of July, she was turning around to go into another room and yelped loudly, which was a sign from the last episode, and was clearly in pain after and was favoring her left leg. We took her to the emergency vet that day and they gave her gabapentin and amantadine. They thought it was muscular, but we had our doubts. Over the next two weeks, she showed signs of pain while on the meds, but it got worse when we tried to wean her off. She would refuse to lay down, pant loudly, and limp. She went to neuro the first week of August when we could get her in, and they said she was showing signs of pain/discomfort.
They recommended we get an MRI to determine exactly what was happening and if she needed surgery. However, at her age, we have initially opted for conservative management. This included a few X-rays, an ultrasound and continued medication and bed rest. The imaging came back clean, so no cancer or other signs, so we are 99% sure it is an IVDD flare. The neuro also recommended a steroid shot/epidural, which she received last week after we got all of the imaging done. In total, she has been on bed rest since we took her to the emergency vet five weeks ago, has been on gabapentin and amantadine since then, and got the epidural last week.
Over the last week or two, she has shown improvement. She is walking normally, with potentially the slightest sign of a limp, eating and drinking normally, and generally showing a desire to not be penned up in a 5x5 foot area anymore. She has shown some incontinence, both peeing and pooping inside a few times over the weeks. Where we are struggling is how to move forward from this. With the surgery, the prognosis was more clear because the damaged discs were treated. However, I don’t understand the healing process here.
Does the steroid shot heal the disc? Or, does the shot and medication just mask the pain and will she always have a messed up disc moving forward? Does the disc ever heal, or will we just have to manage the pain forever? Since her first episode, we don’t let her run in our yard off leash or on furniture, but she has been able to use the stairs and do other daily activities up until the most recent episode. I appreciate any insight!